The Lamp February 2025

MEMBERS DELIVER HOME TRUTHS TO RAMSAY

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NSW Nurses and Midwives’ Association

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Sydney Office

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Danielle Blasutto

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Editorial Committee

Shaye Candish, NSWNMA General Secretary

Michael Whaites, NSWNMA Assistant General Secretary O’Bray Smith, NSWNMA President

Michelle Cashman, Long Jetty Continuing Care

Richard Noort, Justice Health

Michelle Cutler, Tweed Hospital

Diane Lang, South East Regional Hospital, Bega Valley

Karen Hart, Wagga Wagga Base Hospital

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The Lamp ISSN: 0047-3936

General Disclaimer

The Lamp is the official magazine of the NSWNMA. Views expressed in articles are contributors’ own and not necessarily those of the NSWNMA. Statements of fact are believed to be true, but no legal responsibility is accepted for them. All material appearing in The Lamp is covered by copyright and may not be reproduced without prior written permission. The NSWNMA takes no responsibility for the advertising appearing herein and it does not necessarily endorse any products advertised.

Authorised by S. Candish, General Secretary, NSW Nurses and Midwives’ Association, 50 O’Dea Avenue Waterloo NSW 2017

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14

COVER STORY

‘We are not being supported’ Nurses tell Ramsay directors a few home truths.

PRIVATE HOSPITALS

Healthscope threatens Christmas pay packets

Australia’s second-largest private hospital operator, Healthscope, has docked the pay of some nurses and midwives who it claimed had refused to perform non-clinical duties and data entry.

16

PRIVATE HOSPITALS

Private equity sickens our healthcare services

Private equity investment put Healthscope deep into debt and patients are paying the price.

18 PUBLIC HEALTH

The State government can resolve our PHS pay and conditions at any point

The NSWNMA will argue a Special Case in the Industrial Relations Commission that will include a 35 per cent pay increase over three years.

22 AGED CARE

Estia members overturn aged care language ban

Speaking a language other than English in the tearoom is no longer a punishable offence at Estia Health.

24 MIDWIFERY

NMBA report delivers a bleak outlook for midwifery

A major new report on Australia’s midwifery profession has found that more than a third of midwives surveyed are considering leaving the industry due to poor working conditions.

COVER : Karen Gage and Carol Cooke Photographed by Sharon Hickey

Candish

GENERAL SECRETARY

Our pressure is just ramping up

The government has forced its paltry pay offer of 3 per cent per year for three years into the NSW Industrial Relations Commission (IRC). This shows utter contempt for nurses and midwives.

The NSWNMA will launch a legal challenge to the state government’s unilateral imposition of a 3 per cent per annum pay increase for nurses and midwives for three years.

NSWNMA members in the Public Health System have just voted to endorse a Council decision to lodge a counter position against the government’s application for a miserly pay rise in the IRC.

The government cannot be allowed to ram through a three-year award that offers only 3 per cent per annum, and no improvements to conditions. It remains obstinate and tin-eared in response to our reasonable claim for better pay and conditions in the public health sector.

We will now continue our fight on two fronts: we will continue to campaign in the community through our lobbying and political campaign, and we will counter the government’s application with a Special Case in the IRC.

The NSWNMA will seek a 35 per cent pay increase over three years. The Special Case will contain evidence from experts to provide a compelling case for a fair and just pay increase. It will not only counter the government’s insulting application but go even further to outline why you are worth more for the important work you do. We will also argue for a thirty per cent increase in night duties, an increase in sick leave to 20 days and a meal allowance for Patient Transport Services.

A significant consequence of entering into arbitration in the IRC is we can no longer engage in industrial action. If the government thinks this means we will be passive and quiet, it is gravely mistaken. On the contrary, our pressure will ramp up in new ways.

Our political and community campaign will intensify. We have no intention of walking away from this fight, and our priority is to force the government to make a decent pay offer.

We have substantial community support and harnessing that support is pivotal to our campaign.

It is important to note that the government can come back to the negotiating table at any point to reach a fair agreement outside the IRC. We have substantial community support and harnessing that support is pivotal to our campaign.

The drastic action recently taken by psychiatrists shows that all is not well within our Public Health System and the government should value the contribution of its practitioners including nurses and midwives.

RAMSAY NURSES AND MIDWIVES SPEAK TRUTH TO POWER

The state government is not the only intransigent employer we have to deal with at the moment. In this month’s Lamp we look at the tremendous campaign run by our members at Ramsay Health Care (see p8).

Ramsay under its founder Paul Ramsay historically had a credible record in working with its nurses and midwives to provide leading care in private hospitals.

At Ramsay’s annual general meeting at the Sheraton Hotel on November 26 the contemporary ultra- corporatist version of Ramsay management was told some home truths by very brave and articulate NSWNMA members with decades of service and experience at the company.

“From the coalface, I want you to know that your patients are not getting the best care,” a midwife, Carol Cooke, told the subdued directors of the company before an audience of shareholders.

Another Ramsay nurse, Deanna Hayes told the board: “You say Ramsay is living by the mantra of people caring

for people. This certainly isn’t obvious to your workforce.”

These were not isolated voices. The Ramsay board only had to look out the windows of their luxury hotel to observe a sea of their employees from a broad range of Ramsay facilities amplifying those messages – to the media and the public.

The Ramsay board should show some respect to these employees who have been the foundation of the company throughout its history, acknowledge their concerns and act to improve their wages and conditions. The biggest beneficiary of such responsible action will be their patients.n

Apology

In the previous issue of The Lamp, we made an error in an article titled ‘Kate Recognised as “Lifetime Ally”’. In direct quotes from professional officer Kate Adams, the recipient of an ally award for her lifetime support of CATSINaM, we used an acronym instead of spelling out Aboriginal and Torres Strait Islander. This acronym is considered outdated and offensive, and we regret any offence caused. This is not how Kate answered, and we acknowledge the importance of accurately reflecting her words.

Additionally, we mistakenly quoted Kate as referring to Indigenous health practitioners when she in fact said Indigenous nurse practitioners.

We sincerely apologise for these errors. For members seeking more information on culturally respectful language in a health context, we recommend the NSW Health publication ‘Communicating Positively: A Guide to Appropriate Aboriginal Terminology’ (2019).

Have your Say

Featured Letter

Nursing education: A passion for growth and continuity of care

I’ve been an educator for almost 25 years. Most of this time has been spent in secondary schools as a physical education and English teacher.

However, about 10 years ago I took a leap and went back to university to train as a registered nurse. Since graduating in 2017, I’ve worked as a registered nurse in general practice, critical care, and most recently in aged care. I’ve also continued to work as a teacher on a part-time basis.

Living and working in a regional area has given me a unique perspective on healthcare, and primary health care is where I’ve truly found my calling.

What I love about primary health care, particularly in aged care, is the ability to provide continuity of care.

It’s not just the nurses providing care but a huge team involving carers, allied health professionals, catering, and housekeeping. Together, we ensure our residents receive the best possible care and that to me is what makes it all so rewarding.

The autonomy nurses have in aged care is something I value deeply. The role we play in making decisions that impact residents and their families’ lives cannot be overstated.

When the opportunity came to step into the position of education coordinator at an aged care facility, I jumped at the chance. Finally, I could combine my two passions of nursing and teaching.

Since settling into the role, I’ve had the exciting challenge of creating educational programs to upskill our staff.

One initiative that’s been particularly well received is the enrolled nurse focus group, where nurses suggest topics they’d like to explore. A program is then designed to meet those needs in a practical, hands-on approach to keep things engaging.

I’m also proud of the scholarship opportunities we’ve introduced, offering internal scholarships for assistants in nursing who want to become enrolled nurses, and for enrolled nurses who want to advance to registered nurse status.

We’re also offering a Year 12 scholarship to a local student interested in studying nursing. It’s a fantastic opportunity for someone to start their career locally and make a difference locally.

These initiatives, along with the scholarships, are shaping the future of healthcare in our region and I’m thrilled to be a part of it.

Lucy Downey, teacher, nurse educator & comedian

Featured Letter

Give nurses and midwives the pay they deserve

It’s time NSW nurses and midwives are given what they deserve – a 35 per cent pay rise over three years. Surely, if this current state government can give “a historic pay deal” to NSW police officers of up to 39 per cent, a decent pay rise to nurses and midwives is not too much to ask?

I am a registered nurse and clinical educator at a large public hospital and university on the Central Coast. I can testify firsthand how this current state government is failing to give the public the best possible health care this country has to offer by neglecting to invest in its nurses and midwives.

The situation in our hospitals and public health clinics is dire.

It is estimated that 8 out of 10 nurses and midwives are considering moving interstate in the next five years.

I personally know of more than a dozen nurses who have already left my local health district for better conditions and pay interstate.

1 Of my nursing students, 1 in 5 have applied interstate for new graduate jobs, simply because living conditions and nursing pay is better. It’s not a matter of if but when more nurses and midwives will leave this state for better conditions and pay. The NSW health system is crumbling and without an attractive rate of pay for nurses and midwives, it is only going to get worse.

We need new money in the health budget for pay rises to attract more nurses and midwives so we can provide the best health care in this country.

It is against our ethos as nurses and midwives to completely walk out on our patients. We won’t do it. It’s not our nature.

We can’t fight like public transport workers and public school teachers and just not provide a service. Minister for the Central Coast David Harris MP and the Minns Government know it and bank on our compassion.

So, we are calling on you, our past, present and future patients, the people of NSW to tell this state government that nurses and midwives matter.

We urge you to write to your local MP demanding they give us the conditions and pay equality we deserve.

Hayden Jaques, Gosford Hospital

I get paid more to work at Woolies as a baker than as a nurse in NSW Health.

I'm a 36-year-old single mother to a six-year-old daughter.

I work for NSW Health. 32 hours a week. I was working eight additional hours with a surgeon privately in his rooms, until he retired.

Before I was a registered nurse, I worked at Woolworths for 16 years in the bakery. I did an apprenticeship in baking and pastry cooking, moved into management, and later stepped back into a baker's role while I studied nursing.

In 2019, I started my nursing career. Recently, with the cost of living I have been looking for additional work. Working 40 hours a week, I qualify for the low-income energy rebate and 86 per cent childcare subsidy. Now, without my additional eight hours of private work, I have had no choice but to seek reemployment at Woolworths, casually baking overnight and working as a registered nurse in theatres during the day. (When should I sleep?).

After completing my first six-hour shift at Woolworths, I was surprised to see, with the generous penalty rates paid, I was averaging $12 more per hour than my base rate as an RN 6 at NSW Health.

How sad that after three years of full-time study, a $20,000 HECs debt, and my sixth year in the nursing field working in the perioperative environment, I earn more at the job I started in at 15 years old.

During the COVID-19 pandemic, I was deployed to the ICU. With minimal training, I was scared I would bring home COVID-19 to my three-year-old daughter, as I witnessed people dying of the disease daily. All while living in isolation as a single mum with no support.

Despite this, nurses and midwives are still so undervalued and under paid.

Now, I am now stuck with a dilemma. Do I leave nursing, a job I love and am proud of, to bake bread at Woolworths so that I can financially provide for myself and my daughter? I don't want to leave the nursing field, but unfortunately it is now something I must consider for my future financial security.

Danielle Anderson

‘We are not being supported’

Nurses tell Ramsay directors a few home truths.

“I’m a proud employee of North Shore Private. I stood by you. For three years I wore a N95 mask – do you know what that's like in PPE? … I did that for you – and where are you behind me now?”

With those remarks, nurse and midwife Carol Cooke reminded the Ramsay Health Care board of directors of its responsibilities to the company’s nursing staff – and their vital role.

Carol was among the NSWNMA members who spoke from the floor during Ramsay’s annual general meeting at the Sheraton Hotel in Sydney on November 26.

She said she had been at North Shore Private since before the hospital opened 26 years ago.

“From the coalface, I want you to know that your patients are not getting the best care,” Carol told the nine directors seated on the stage.

She held up her Ramsay certificate for 25 years’ service, adding, “But I’m not being supported.”

She said Paul Ramsay, who founded the now-global company in Sydney in 1964, used to work with the nurses.

“He would give us whatever equipment we wanted, and we were well staffed.”

Today, however, “I start at 7am and I finish at 7:30 at night. I don't get breaks. I answer the phone, I admit patients, I get water, I change flowers, I support women in labour.”

“I want you to know that when I come to work not only am I caring for your women and your babies, I also have lives in my hands.

“From the coalface, I want you to know that your patients are not getting the best care.”

— Carol Cooke, NSWNMA branch North Shore Private

OPEN YOUR EYES

“I’m your patient safety and without me and all my team here you would not have safe practices and it's getting unsafe on every shift.

“Without nurses, your patients will not come.

“You’ve got to be really worried that outside in the street you have got nurses who have taken time off to be here unpaid to let everyone know that we are hurting, our patients are hurting, our patient safety is down, our ratios are very poor.

“You need to open your eyes and talk to people like me because I am the eyes and the hands to the doctors.

In reply to Carol, Ramsay chairman David Thodey, a former CEO of Telstra, said, “We are very conscious of the work you do and how dependent we are on what you do every day.”

Thodey said, “We want to find a way through this [industrial dispute] and the only way we can do this is by talking, so let's keep that dialogue going.”

He added, “If there's anything in terms of patient care or in terms of staff care that you're worried about, please let us know.”

Carol was followed by Deanna Hayes, NSWNMA branch secretary and delegate at St George Private Hospital, who said she had been nursing at St George Private for 23 years.

“You said we need to keep talking; we've been in this protracted enterprise bargaining for 20 months already,” Deanna told Thodey.

“We've told them [Ramsay management] stories from the floor from representatives from all over NSW … and we still can't convince you that this is what we need.

“You say that Ramsay is living by their mantra of people caring for people. This certainly isn't obvious to your workforce.

“Ramsay have refused to acknowledge their valuable staff – most of whom have university degrees – in a cost-of-living crisis and we are the people who keep your business making profits.

“When will Ramsay finally agree to our reasonable demands around a pay rise that reflects that we are valued and agree to clauses to allow us to provide safe staffing for your patients?” n

“You say that Ramsay is living by their mantra of people caring for people. This certainly isn't obvious to your workforce.”

—

Deanna Hayes, NSWNMA branch St George Private

LEFT: DEANNA HAYES BELOW: RAMSAY'S ANNUAL GENERAL MEETING

Southern Highlands team join Sydney rally

About two dozen nurses from Southern Highlands Private Hospital (SHPH) in Bowral travelled to Sydney to join the march and rally at the Sheraton Hotel, the venue for the Ramsay AGM.

Among them was the NSWNMA branch secretary at SHPH, Ewan Gemmell, who said the action was very successful.

“I think our members got a lot out of it – they enjoyed it and felt like they were making a bit of a difference,” said Ewan, a theatre nurse.

“About 60 to 70 members got into the Ramsay AGM and I think that caused the board a fair bit of discomfort.

“The NSWNMA speakers at the AGM were very good and addressed many of our concerns.

“Other shareholders who attended the AGM were able to hear our concerns without Ramsay being able to put their spin on it.

“After the AGM, some shareholders actually congratulated a few of the nurses for their polite and professional conduct, which was good.

“We weren’t there to create a scene, we just wanted to be heard.”

Ewan said he realised during the AGM that “Ramsay is just a business. They [the board members] are businesspeople and I don’t think they really understand what we nurses do.”n

Ramsay offer voted down for a third time

It seems the management of Ramsay Health Care won’t take no for an answer.

In the dying days of 2024, Ramsay Health Care made another unsuccessful attempt to force a substandard enterprise agreement (EA) onto their NSW nursing and midwifery workforce.

The company put its preferred EA to a vote of employees for an unprecedented third time.

And for a third time, nurses and midwives voted ‘No’.

In this latest ballot, which closed on 17 December, 79 per cent of eligible employees voted, and 55 per cent voted ‘No’.

The vote followed a 24-hour strike by nurses and midwives at 17 Ramsay hospitals across the state on November 26.

Believed to be Australia’s biggest private sector health strike, it was part of an ongoing campaign in support of a 20 per cent wage increase over three years and safer staffing levels.

RAMSAY STRIKE IN SYDNEY CBD

The Ramsay campaign is a major part of an unprecedented level of industrial action over pay and conditions at private providers, including Healthscope in NSW (see story page 14).

“Last financial year, Ramsay turned over almost $900 million in profit. We know they can afford to pay our hardworking nurses and midwives what they’re worth.”

— General Secretary Shaye Candish

General Secretary Shaye Candish said the November 26 strike followed 20 months of talks and 18 bargaining meetings involving a NSWNMA team that included union officials and hospital branch delegates.

She said the NSWNMA campaign of strikes and work bans had forced the company to lift its pay offer from 9 per cent over three years in the first vote, to 16 per cent over three years in the most recent ballot.

However, negotiations fell through late last year when Ramsay backed away from safe staffing clauses that had been agreed in principle.

Lack of progress on ratios or safe staffing led the NSWNMA bargaining team to recommend a ‘No’ vote to members for a third time.

“A majority of members voted to support this recommendation despite a very strong push by Ramsay management to persuade staff to vote yes, including dangling an offer of backpay close to Christmas,” Shaye said.

“Last financial year, Ramsay turned over almost $900 million in profit. We know they can afford to pay our hardworking nurses and midwives what they’re worth, by funding a pay rise that addresses inflation and cost of living pressures,” she added.

The NSWNMA wrote to Ramsay seeking to re-open negotiations in February.

“I have never felt prouder. Proud to be a nurse, proud to be associated and working with so many strong and resilient people.”

— Carlie

Morgan, NSWNMA branch Wollongong Private

STANDING UP TO CORPORATE GREED

During the November 26 strike, about 600 Ramsay staff closed Elizabeth Street in Sydney’s CBD as they marched from Hyde Park to the Sheraton-on-the-Park Hotel where the company was holding its annual general meeting.

About 80 Ramsay nurses who are Ramsay shareholders entered the AGM wearing their NSWNMA scrubs, while the rest rallied outside. Two NSWNMA member shareholders asked questions of the Ramsay board (see story page 8).

Some long-serving Ramsay nurses and midwives are shareholders because the company’s late founder

Paul Ramsay awarded shares to his employees in the early 2010s.

Ramsay nurses from the Illawarra, Southern Highlands and Shoalhaven regions boarded buses to join the Sydney rally.

Among them was Carlie Morgan, secretary of the NSWNMA branch at Wollongong Private Hospital.

She told the rally, “I have never felt prouder. Proud to be a nurse, proud to be associated and working with so many strong and resilient people, and proud to be standing here in solidarity with you all to show Ramsay how we stand up to corporate greed.”

When interviewed by WIN TV News, she said, “We thought we were making progress in negotiations and we managed to reach a bit of a verbal agreement regarding some safe staffing clauses. However, when we met with Ramsay again that offer was revoked.”

“As a femaledominated workforce, we need to close the gap. We need ratios, we need fair pay.”

— Renae Maher, NSWNMA Branch Albury Wodonga Private

Renae Maher, NSWNMA Branch President at Albury Wodonga Private Hospital, said, “As a femaledominated workforce, we need to close the gap. We need ratios, we need fair pay.”

She added, “We need our staff on the border not going across to Victoria where they got a 28.5 per cent pay increase over four years. We are losing staff.” n

‘This campaign will continue until we get a resolution.’

In Port Macquarie, Channel 7 News covered a roadside rally of NSWNMA members from Port Macquarie Private Hospital. NSWNMA delegate Elizabeth Holland told 7 News that nurses were “sick and tired of doing double shifts and tired of doing overtime for no reward. This campaign will continue until we get a resolution.”

NSWNMA member Gail Malagre said understaffing meant working conditions were unsafe, particularly on night shift with one nurse to 10 patients.

Rohan Smith, Port Macquarie Private branch president said he hoped the strike would “give Ramsay a clear understanding that we’re still not happy with their arrangements and their pay offer and their consideration of staff ratios.”n

‘Members are getting frustrated with Ramsay’s delay and what feels like bullying tactics.’

In Coffs Harbour, passing motorists tooted support for NSWNMA members from Baringa Private Hospital and Ramsay Surgical Centre who staged a roadside rally with placards promoting the campaign.

Some Coffs Harbour members also travelled to Sydney for the rally. They included Coffs Harbour Baringa Branch Secretary Melissa McDonough.

“Members are getting frustrated with Ramsay’s delaying and what feels like bullying tactics,” Melissa told the Coffs Harbour regional newspaper News Of The Area.

“Recently, they threatened that if staff don’t accept their offer, they would be unable to pay employees their backpay, for the financial year 2023–24.

“Now they are telling employees that they cannot confirm the current offer will remain if it is not accepted.

“Added to this, they are still refusing to commit to safe staffing ratios.”n

Backpay owed to thousands of Ramsay nurses

Commission upholds NSWNMA case against Ramsay over miscalculated annual leave.

The NSWNMA has achieved an historic win in the Fair Work Commission (FWC) that will deliver backpay to thousands of current and former Ramsay Health Care staff this year. The Association estimates Ramsay’s total backpay liability to be well over $10 million.

Some nurses could be owed several thousand dollars after the Commission agreed with the NSWNMA that Ramsay had been miscalculating annual leave payments for up to six years.

Thousands of nurses will now need to be backpaid for shift and weekend penalties they would have received if they hadn’t taken annual leave.

NSWNMA General Secretary Shaye Candish said Ramsay decided not to appeal the decision to a full bench of the FWC.

Shaye said it was too early to know exact backpay amounts but a full time, shift-working RN could receive more than $1000 per year for up to six years.

“We understand that Ramsay needs to review about two million payslips,” she said.

“It could take several months for Ramsay to calculate backpay for all affected current and former employees.”

The union took Ramsay to the FWC because it believed Ramsay had been miscalculating payments to staff while on annual leave due to a misinterpretation of the Ramsay enterprise agreement (EA).

The case centred on the interpretation of EA clauses which dealt with the calculation of annual leave loading, shift payments and allowances while staff were taking annual leave.

The NSWNMA argued that clauses 8.1.19 and 8.1.20, when read together, meant that nurses who take annual leave should be paid shift and weekend penalties they would have earned had they not been on leave.

The union also argued that nurses who take annual leave should additionally receive annual loading of 17.5 per cent or the average of allowances and shift penalties from the previous six months.

Ramsay argued that the EA had been written ambiguously and meant something other than what the words said.

“It could take several months for Ramsay to calculate backpay for all affected current and former employees.”

— General

Secretary Shaye Candish

The company asked the FWC to have the agreement varied and rewritten to reflect their interpretation.

FWC Deputy President, Thomas Roberts, found that Ramsay’s case should be dismissed and the EA not varied.

He also found the NSWNMA’s interpretation of how annual leave is paid was correct.

The NSWNMA says backpay should go back to 2018, though Ramsay has yet to respond to the Association on that point. n

‘The care factor’s gone – you don’t have time to care.’

NSWNMA delegate at St George Private Hospital, Amelia Gasparotto. was interviewed by The Australian Financial Review during the 24-hour Ramsay strike on 26 November.

Amelia said nurses were “fired up and angry” over the decline in wages relative to the cost of living and the company’s protracted bargaining.

“We’re all at breaking point,” she said. “You see other professions getting wage hikes – the police have been offered 40 per cent, teachers getting 14 per cent. We all deserve a pay increase because we want the best nurses giving the best care.”

Amelia told the AFR that Ramsay did not have enough staff to complete work or relieve shifts, meaning “a lot of times you’re expected to stay back”.

“I’ve been here 27 years and I can see a definite decline with our expectations and the way care is delivered. It just seems to be very profit driven. The care factor’s gone – you don’t have time to care.”n

Backpay – what Ramsay must do

Ramsay needs to backpay nurses so that payments for annual leave are as follows:

1. Any person who goes on any annual leave should receive the afternoon, night, Saturday and Sunday shift penalties they would have received if they had worked.

2. In addition a person on the first four weeks of accrued annual leave should receive 17.5 per cent of the payment in item 1 OR the average of afternoon and night shift penalties and other allowances (on-call, in-charge, laundry, travel + motor vehicle, meal allowance on overtime, qualification allowance, lead apron allowances) they received in the previous six months divided by the days they worked in that period).

Most people will have received only one of those payments in the past.n

Healthscope threatens Christmas pay packets

Australia’s second-largest private hospital operator, Healthscope, has docked the pay of some nurses and midwives who it claimed had refused to perform non-clinical duties and data entry.

Just before Christmas, nursing staff of at least two Healthscope NSW hospitals – Newcastle Private and Norwest Private – were threatened with pay cuts of up to 30 per cent. Healthscope, which pays its NSW nurses less than their counterparts in Queensland, has refused to seriously negotiate with the NSWNMA on improved pay, staffing ratios and other conditions.

Healthscope NSW nurses are 2.4 per cent behind NSW public sector wages. Also, they do not have salary packaging and so have significantly lower take-home pay.

‘There is a lot of anger over the pay cuts – a lot of members were asking; can we walk out now?’

NSWNMA members decided to implement work bans at seven NSW Healthscope hospitals –Campbelltown Private, Lady Davidson Private, Nepean Private, Newcastle Private, Northern Beaches, Norwest Private and Sydney Southwest Private.

Healthscope then issued a notice threatening to cut pay by 7.5 per cent across the board.

It withdrew the notice after the NSWNMA took the issue to the Fair Work Commission.

HARSH PENALTIES

On the day bans were due to be implemented (13 December) the company issued a revised notice with harsher penalties applying to a more specific list of nursing roles and work units.

For example, Healthscope estimated a direct care RN in an emergency department spends 200 minutes per shift on non-clinical duties and 10 minutes per shift on data entry.

The company therefore decided a ban on non-clinical duties (such as cleaning, moving beds, emptying bins and making beds) and data entry should be punished with a total pay cut of 29.17 per cent.

In another example, Healthscope estimated a surgical ward speciality coordinator spends 90 minutes on non-clinical duties and 60 minutes on data entry and should suffer a total pay cut of 31.25 per cent.

The NSWNMA’s Healthscope campaign committee, which includes member representatives from all affected hospitals, called a meeting on 13 December and decided to call off the work bans.

ICU nurse Sheridan Brady, president of the NSWNMA branch

SHERIDAN BRADY, PRESIDENT OF THE NSWNMA BRANCH, NORTHERN BEACHES HOSPITAL

at Healthscope’s Northern Beaches Hospital, said the campaign committee did not want nurses and midwives to risk losing a large chunk of their pay – especially leading into Christmas.

“This is an act of corporate greed by Healthscope,” she said.

By threatening to dock pay, Healthscope was admitting that nurses and midwives were routinely expected to perform tasks other than caring for patients.

“We are not cleaners or wardsmen or kitchen hands ... we should not be sacrificing precious nursing time with our patients,” Sheridan said.

When The Lamp went to press it was unclear how many nurses and midwives had their pay docked.

Some nurses subject to pay cuts seemingly did not participate in bans while nurses who engaged in partial bans were docked the same amount as others who fully implemented all bans.

‘This is an act of corporate greed by Healthscope.’

Sheridan said early indications were that amounts deducted ranged up to $125 dollars per shift.

QUESTIONABLE NUMBERS

“We don’t know how Healthscope came up with their numbers,” she said.

“For example, at Northern Beaches ICU they estimated our non-clerical activities at 35 minutes per shift but we don’t actually do any of those activities.

“We don’t know how they decided which members took part in the bans, or to what extent they took part.

“Some people who initially said they would take part in the bans decided not to do so for safety reasons on the day – for example, the urgent need to move a bed in the theatre – but they were still docked.

“There was a lot of anger over the pay cuts with members asking; can we walk out now?

“However, the law says a union must give three days’ notice of protected action to the Fair Work Commission otherwise any strike would be unprotected.

“Industrial action by the employer –such as Healthscope’s pay cuts – only requires one day’s notice.

“Had Healthscope given us three days’ notice the bans may or may not have gone ahead.”

INTIMIDATING BEHAVIOUR

She said some members reported instances of intimidating behaviour by Healthscope.

“Some managers were asking nurses and midwives whether they were union members and whether they were opting in or out of protected action.

“It didn’t happen at every hospital or in every unit but some staff were made to feel very uncomfortable.

“People were upset because it really does show how little Healthscope value their nursing workforce.

“If you want to come to an agreement with your staff then alienating your entire nursing workforce seems a very odd way of going about things.

“It’s not as if there is a glut of nurses and if you mistreat one you can easily replace them with another.”

The Fair Work Commission is scheduled to hold a two-day hearing on the Healthscope pay cuts in early March. n

Healthscope motivated by ‘greed and desperation’

NSWNMA General Secretary Shaye Candish said a key reason our members at Healthscope voted to take protected industrial action was because the the company had repeatedly refused to acknowledge that there were issues with nurses and midwives’ workloads.

Healthscope’s pay cuts amounted to a major attack on members’ right to participate in protected industrial action, she said.

“It reflects the greed and desperation of Healthscope’s owner Brookfield, a multi-billion-dollar Canadian company which has saddled Healthscope with a huge pile of debt,” Shaye said.

“Healthscope is not only fighting with its staff but also involved in a huge funding dispute with private health insurers.”n

Private equity sickens our healthcare services

Private equity investment put Healthscope deep into debt and patients are paying the price.

In October 2024, Australia’s second-largest private hospital operator, Healthscope, started charging customers of certain health funds including Bupa a $100 gap fee for overnight stays.

Healthscope told patients if they were upset by the additional charge they should switch health funds.

Patients thus became the meat in the sandwich in a battle between the funds and Healthscope, owned by the private equity (PE) arm of giant Canadian firm Brookfield.

Rachel David, Chief Executive of Private Healthcare Australia, the peak body representing private health funds, described the Healthscope fee as “a deeply unethical move”.

“Targeting patients is a new low. I have never seen a hospital group do this before,” she told The Australian newspaper.

David said Brookfield was “holding privately insured patients hostage and trying to bully health funds into paying them more so they can increase profits”.

‘Brookfield was only ever in the Australian hospitals market for the short term.’ — Rachel David, Private Healthcare Australia

“Brookfield was only ever in the Australian hospitals market for the short term,” she added.

“It is trying to squeeze out as much profit as possible before it abandons Healthscope hospitals, potentially making private healthcare unaffordable in the process.”

In November, Healthscope cancelled its funding arrangements with Bupa and a collective of not-forprofit insurers.

This affected more than six million people, the Australian Financial Review reported.

NO GOVERNMENT BAILOUT

Brookfield paid $4.1billion for Healthscope in 2019.

Its investment has not yielded the expected profits so Healthscope wants health funds to pay a bigger share of treatment costs.

The insurers said they and their customers should not have to pay for Brookfield’s poor commercial decisions.

Healthscope then launched a PR campaign against the insurers.

The Australian Financial Review described the PR blitz as “a warning

HEALTHSCOPE IS OWNED BY GIANT CANADIAN PRIVATE EQUITY FIRM BROOKFIELD.

to patients that hospitals will close, surgery waiting lists will grow, patients may have to travel further for rehabilitation, and out-of-pocket expenses will rise if insurers don’t pay more for procedures”.

Health Minister Mark Butler has commissioned a review of the health of the private hospital sector and Healthscope appears to be hoping for government help.

However, Butler told the Australian Financial Review in December there was “no silver bullet or governmentfunded bailout on the cards”.

SADDLED WITH DEBT

Rachel David’s description of Healthscope as a short-term investment points to the major flaw in the PE investment model (private equity refers to investment in businesses that are not publicly traded on stock markets).

PE firms don’t use a lot of their own money when they buy companies. Instead, they borrow money from institutional investors (including superannuation funds) to buy businesses for the purpose of selling or publicly listing them on the stock market within a few years.

INVESTORS ARE PROMISED FAT PROFITS.

These transactions are funded by debt but it is the business being bought – not the PE firm – that takes on the debt.

According to The Australian , Brookfield has loaded up Healthscope with about $1.6 billion of debt.

Healthscope must pay this back to a syndicate of at least 25 lenders at a time when the industry is struggling with higher costs.

A common PE tactic is to sell the target company’s physical assets such as real estate then rent the properties back.

This can extract a fast profit for the PE firm but often burdens the target company with high rents.

When Brookfield bought Healthscope, it sold Healthscope’s properties to NorthWest Healthcare and Medical Properties Trust for about $2 billion combined.

One of Healthscope’s new landlords, Medical Properties, has since sold the Healthscope properties it owned to another company, to which Healthscope must pay rent. n

Private equity buying spree

A study published in the Medical Journal of Australia in April 2024 found PE firms made at least 75 acquisitions of healthcare assets in Australia during 2008–2022, at a total cost of at least $24 billion; the number of identified acquisitions rose from three in 2008 to 18 in 2022.

The study defined healthcare assets as hospitals, clinics, imaging services and IVF providers.n

US economy ‘held hostage’ by takeover merchants

In the United States, which gave birth to the private equity model, there is growing concern over PE investment in health care.

A big hospital group owned by PE firm Cerberus Capital recently collapsed, prompting politicians to call for restrictions on PE involvement in health care.

Pulitzer Prize-winning journalist Gretchen Morgenson, author of These Are the Plunderers: How Private Equity Runs and Wrecks America, describes PE as “a game where a very narrow slice of people wins and everybody else is on the losing end”.

Leading American journalist Chris Hedges says the US economy is being “held hostage by a small cohort of financiers who run private equity firms”.

The biggest include Apollo, Blackstone, the Carlyle Group and Kohlberg Kravis Roberts.

Hedges says the PE business model aims to “buy up and plunder businesses, piling on debt, refusing to reinvest, slashing staff and often driving companies into bankruptcy”.

“Those who run these firms such as Leon Black, Henry Kravis, Stephen Schwarzman and David Rubenstein have

amassed personal fortunes in the billions of dollars.

“The wreckage they orchestrate is taken out on workers who lose jobs or see salaries and benefits slashed; taken out on pension funds that are depleted because of usurious fees; and taken out on our health and safety.”

Hedges reports that residents of nursing homes owned by PE firms experience 10 per cent more deaths “because of staffing shortages and reduced compliance with standards of care”.

“Private equity owns hospitals and has created a health crisis. The PE firms do not serve patients but profits.

“They have closed hospitals especially in rural America. They cut back on stockpiles of vital medical devices including ventilators and personal protective equipment.”n

‘Private equity aims to buy up and plunder businesses, piling on debt, refusing to reinvest, slashing staff and often driving companies into bankruptcy.’ — Journalist Chris Hedges

The State government can resolve our PHS pay and conditions at any point

The NSWNMA will argue a Special Case in the Industrial Relations Commission that will include a 35 per cent pay increase over three years.

The NSW Government has let nurses and midwives down by forcing its public sector pay claim into the courts, says NSWNMA General Secretary Shaye Candish.

Shaye says this leaves the NSWNMA with no choice but to respond to the government’s application of 3 per cent per annum over three years with a Special Case in the NSW Industrial Relations Commission (IRC).

“Our fight will continue on two fronts: campaigning in the community through a political campaign and responding to the government’s application in the IRC, she said.

“A negotiated outcome outside the IRC is still an option. Labor can put forward a decent offer at any stage.”

A full bench of the IRC will weigh up the arguments put forward by the government and the NSWNMA and then decide what your wages will look like.

The NSWNMA will be arguing for a rise of 35 per cent per year over three years.

Shaye Candish says we have reached this point because of the government’s recalcitrance.

“This is the result of the appalling failure of the government to negotiate with nurses and midwives,” she said.

“Every step of the way we have negotiated in good faith. This government has let nurses and midwives down, and we plan to make them accountable.

“We will put forward the biggest case ever run in our state’s history.”

The NSWNMA will argue for a pay rise, over multiple years, that recognises:

• two decades of intensifying workloads which nurses and midwives have not been compensated for

• evidence regarding the recruitment and retention challenges the public health system is experiencing

• the productivity gains missed out on for over a decade

• a correction of the gender-based undervaluing of nursing and midwifery in NSW.

WE MUST ENGAGE THE COMMUNITY

Going to the IRC with a counter claim means we will not be able to take industrial action in support of our claim. If we take industrial action the IRC will not hear our case.

Shaye Candish says it is vital we maintain the momentum of our campaign in a different way.

“It is still possible for this Labor government to come back to the negotiating table and reach a fair outcome outside the IRC.”

— NSWNMA General Secretary Shaye Candish

“This is where our political and community campaigning is crucial. We must maximise the pressure on this government.

“The support of the community has always been pivotal in our past campaigns and so it will be this time. Recent polls show that we have overwhelming support from the public for our wage claim (see box).

“We need all state MPs to commit to backing our fight for additional funding for health and to support our campaign for a fair wage increase that will enable the recruitment and retention of staff necessary to roll out ratios in NSW.

“I urge members to contact your MP and encourage your family, friends and colleagues to do the same. We need MPs hearing from nurses, midwives and their allies all day, every day!

“It is still possible for this Labor government to come back to the negotiating table and reach a fair outcome outside the IRC. The government can end this lengthy legal exercise at any point.”n

What we will be seeking in our special case

• 35 per cent pay increase over three years

• Night duties increase to 30 per cent (in line with other states)

• Sick leave increase to 20 days

• Meal allowance for Patient Transport Services

Community support for us is strong

A poll conducted in December by the RedBridge group found overwhelming support for our pay campaign among the public.

70 per cent of participants supported a 15 per cent pay increase, including 71 per cent of Labor voters, 66 per cent of Coalition voters and 90 per cent of Greens voters.

Support increased to 80 per cent overall when respondents learned nurses and midwives were leaving NSW due to the pay disparity with other states, especially with Queensland.

Sixty-seven per cent of voters said the ongoing pay dispute with nurses and midwives decreased their confidence in the NSW Government’s ability to manage healthcare, and 61 per cent said their view of the government was shaped by whether it increased the pay for nurses and midwives.

“MPs need to be supportive in parliament where it counts”

Catriona South RN, Greater Newcastle and Hunter Valley Community Mental Health Branch

“I’ve spoken with Kate Washington, the member for Port Stephens, about our claim for a pay rise. And we’ve also been campaigning in the electorate of Maitland, highlighting our concerns that the local MP Jenny Aitchison is not supporting our pay claim.

Nurses and midwives here are all feeling pretty desperate and disappointed because these politicians have all been outspoken in the past when they have been backbenchers or in opposition. But now that they are in cabinet, the support does not seem to be there even though we have supported them in their campaigns.

Parliamentarians are supportive in person, but we need them to be supportive and advocating for our pay claim in parliament where it actually counts.

Some of the staff here are getting pretty desperate. I know of people working multiple jobs. I know of people working in private hospitals as well as their full-time job, and in multiple wards and doing overtime.

I have been taking part in actions holding signs with messages for the public to see outside the hospital and near Jenny Aitchison’s office. We are leafleting the community near the MP office in the mall, asking

‘I have been taking part in actions holding signs with messages for the public to see outside the hospital and near Jenny Aitchison’s office.’

members of the public to email the MP expressing their support for nurses and our need for a pay rise. We feel that we can’t just sit around and wait for the special case to be heard by the IRC because we feel that it will take another year or 18 months to be decided, and people are desperate now.

It feels like we are doing something, not just sitting back and taking it. There is quite a camaraderie amongst the members, and you learn a lot about members in other areas, because every area has different challenges.

When we are leafleting, so many people will say to you: ‘My mum is a nurse’ or ‘my sister is a nurse’. Most people are supportive and do think that nurses do need to be paid fairly for the high skilled work that we do.

MAITLAND HOSPITAL MEMBERS AND SUPPORTERS HOLD LOCAL MP JENNY AITCHISON TO ACCOUNT.

“People are very angry about the whole treatment of nurses, and the community support is fantastic”

Kathy Triggell, RN, Wyong Hospital

“We’ve met with our local member David Harris, the member for Wyong.

We put forward how awful the nursing hours per patient day (NHPPD) are and informed him that in a three-week period in August our local health district was 5,000 hours short: that is 625 shifts not provided in our local health district between Wyong and Gosford in a three-week period.

He said he understood that we were short staffed, that there were difficulties trying to employ nurses in our area, and that he had spoken to the Local Health District.

He wasn’t supportive of the 15 per cent pay rise: he said that was too much, and that we hadn’t mentioned it previously and all of a sudden now we are trying to get this percentage which isn’t in their budget.

‘We have been out at the train stations, we have been at markets, we have been putting flyers in letter boxes all down the coast.’

I said to him, ‘I can’t understand why Queensland and Victoria can pay their nurses appropriately and we can’t’. He said: ‘We are up to our eyes in debt'.

We just looked at him. They found the money in those states, so they can surely find it in NSW.

We need our local politicians to stand up and back us. We were the ones that stood behind them when they wanted to be elected.

I expect them to look after their community.

People are very angry about the whole treatment of nurses, and the community support is fantastic.

We have been out at the train stations, we have been at markets, we have been putting flyers in letter boxes all down the coast.

Usually, the response from the community is that we deserve this and the government should pay up.

We have a lot of nurses who are leaving, who have changed careers, and who are not far off retiring. And we have a lot of young nurses that come out of university after threeand-a-half years of study, and they end up with a job that won’t pay the rent. And they have a HECS bill and the cost of living has soared.

If the government won’t give nurses the pay rise they deserve, we are heading for a catastrophe in the health system.

There is a great camaraderie between nurses. We do back each other: that is half of the problem. Nurses are doing overtime and extra shifts because they don’t want to leave their colleagues in a situation where their workload is so heavy.

”Get involved!

We must stand together and fight to win improvements to pay and conditions in the Public Health System.

Scan the QR code and join our campaign!

WYONG HOSPITAL BRANCH MEMBERS HOLD THEIR LOCAL MP DAVID HARRIS TO ACCOUNT.

More money in the pockets of aged care workers from January

Aged care workers should have received their latest wage increase in their first full pay packet for 2025.

The pay increase is a win from the aged care work value cases, prosecuted by the ANMF and other unions in the Fair Work Commission (FWC), which began in 2021.

The cases sought to improve award wages in aged care.

The case was successful, and in July 2023, award rates for direct care workers in aged care increased by 15 per cent.

In March 2024 the FWC made its final wage rates decision for AiNs and PCWs which would mean a total 23 per cent increase for Certificate 3 workers as a result of the work value case.

The FWC held that AiNs and PCW Awards would receive further increases from 1 January 2025 and any final increase from 1 October 2025.

Prior to 1 January the award rate for an AiN with a certificate 3 was $31.24. From 1 January, the new rate is $32.14 – an hourly increase of $0.90.

The FWC also decided that instead of having a classification structure for AiNs in the Nurses Award and the same structure replicated in the Aged Care Award, these two structures should be merged to become one.

The new structure will be in the Aged Care Award, rather than the Nurses Award.

NSWNMA General Secretary Shaye Candish says the pay improvements are proof that collective union power delivers results.

“Members

will need to hold providers to account and we’re here to help you do that.”

–NSWNMA General Secretary Shaye Candish

Aged Care Award increases for AiNs and PCWs in 2025

The increase to Award rates is to be paid in two increments in January and October.

A Certificate 3 direct care worker will receive:

• January 2025 (4 per cent)

• October 2025 (another 4 per cent)

• The total increase from the Work Value Case for Certificate 3 employees working in aged care is 23 per cent.

“This pay rise should be paid to you by your employer as it is funded by the federal government. But we know that not all employers passed on the previous 15 per cent increases until members spoke up.

“So, members will once again need to hold providers to account and we’re here to help you do that,” she said. n

Members should be paid this increase even if they are currently paid above the minimum award rate.

As the majority of carers are covered by the award rate, they will also receive the Minimum Wage increase in July 2025. The minimum rate for an aged care certificate 3 before the work value cases were first implemented in June 2023 was $24.76. After the increase in October 2025 it will be $33.42 – with the July 2025 Minimum Wage to be added. n

Estia members overturn aged care language ban

Speaking a language other than English in the tearoom is no longer a punishable offence at Estia Health.

Workers at Estia Health nursing homes are now permitted to speak languages other than English in the staff tearoom thanks to NSWNMA.

NSWNMA members at Estia initiated a successful multi-union national campaign to change the company’s code of conduct which said: English is to be spoken amongst our employees and other workers in our homes, including in staff rooms.

The issue came to a head in September 2024, after the Association assisted a member who received an Estia disciplinary letter.

The letter alleged the member had “spoken Nepalese in front of other staff members” and may have breached the company’s code of conduct by “failing to create an inclusive work environment by speaking a language other than English”.

Estia withdrew the letter after the union intervened, but the member resigned from Estia as a result of the bad experience.

“A lot of workers were relieved and happy the campaign was successful, but some were disappointed that it took Estia so long to change the policy.”

– Fane Poitaha

The NSWNMA conducted a survey of Estia workers in NSW which showed more than 70 percent who answered the survey wanted the code of conduct changed “to reflect their right to speak their preferred language during their breaks, which are their own unpaid time”.

POLICY KILLED CHAT IN TEAROOM

Sydney AiN Fane Poitaha was an Estia employee and NSWNMA member leader at the time.

She took part in the NSWNMA campaign to distribute the survey among Estia staff members.

“All NSWNMA members at Estia got a union email with a QR code that linked to a simple two-minute online survey,” she said.

“We distributed printed QR codes to non-members because we felt it was important to get the views of as many staff members as possible.

“In my former Estia workplace, close to 95 per cent of staff came from nonEnglish speaking backgrounds.

“None of us disputed that we should speak English when working on the floor and especially in front of residents.

“But tea breaks are our own time – we don’t get paid for them. We should be free to speak our own language and not face retribution.

“While our survey was being distributed, the company put up notices in the tea rooms reminding staff they were not allowed to speak in their own languages.

“Usually in the staff room it was loud; everyone was talking, laughing and socialising.

“But when the company was pushing the English-only policy there was a big change in the tearoom, and not much chatter.

“Some people took their breaks off the premises because they did not want to get a warning.”

THE POWER OF COLLECTIVE ACTION

In an email to members, NSWNMA General Secretary Shaye Candish said the union wrote to Estia management seeking a change to the code “so you can have rules which require respect and inclusion from employees, without the need to put a blanket ban on language during your breaks”.

FANE POITAHA

She added, “We have also raised our concerns about the ban on other languages being unlawful under racial discrimination law and the Fair Work Act.”

“As union members we stand up for respect and we call on employers to value diversity and inclusion as we do. This includes making sure that everyone, no matter what languages they speak, can take their breaks in a supportive and inclusive tearoom.”

The NSWNMA enlisted the support of aged care unions in other states to run a joint national campaign on the issue.

In December 2024, Estia told the NSWNMA it had changed the code of conduct to now say: “Whilst staff may speak their own language in the staff room while on their unpaid break, they should consider the impact on those around them, for example speaking about other staff in a way that is excluding them from the conversation.”

Fane described the result as “a good win which showed workers why we need a union and what we can achieve together. We got more members to join the union as a result of the campaign.”

“This is a significant win for nurses and care workers who were unfairly restricted by the previous policy requiring them to speak English at all times.”

– Shaye Candish

“A lot of workers were relieved and happy the campaign was successful, but some were disappointed that it took Estia so long to change the policy.”

Shaye said that as a result of Estia’s changed policy, “staff can now speak with colleagues, make video calls to family and connect in their own language during break times without fear of disciplinary action”.

“This is a significant win for nurses and care workers who were unfairly restricted by the previous policy requiring them to speak English at all times.

“While clear communication with residents remains a priority, and English remains the language for all work-related interactions, the change

means staff can express themselves in their own language during their free time.

“This victory highlights the power of collective action. The NSWNMA remains committed to protecting workers’ rights and fighting against workplace racism.” n

40 per cent don’t speak English at home

The Australian Department of Health and Aged Care conducted a survey of the aged care workforce in 2024.

Just over 40 per cent of workers who answered the survey said they speak a language other than English at home.

Estia is owned by US private equity firm Bain Capital and operates more than 70 homes in Australia.n

AiNs & PCWs

NMBA report delivers a bleak outlook for midwifery

A major new report on Australia’s midwifery profession has found that more than a third of midwives surveyed are considering leaving the industry due to poor working conditions.

The report, Midwifery Futures: Building the Australian midwifery workforce , also found there are not enough midwives, or current midwifery students in the pipeline, to meet our future needs.

Commissioned by the Nursing and Midwifery Board of Australia (NMBA) and conducted by the Burnet Institute, the report made 32 recommendations under five key areas:

• increasing visibility, governance and leadership of the profession

• scaling-up midwifery models of care

• growing the workforce

• support conditions and career pathways in the workforce

• improving data workforce planning.

New South Wales has the lowest number of midwives per capita in the country, with only 104 midwives per 100,000 population. There are 6,600 practising midwives in the state.

The report authors say that “strong and skilled midwifery leadership is essential for developing the future Australian midwifery workforce”. They call in particular for the appointment of a Chief Midwife in each Commonwealth and state and territory government.

They also call for maternity services that are led by midwives at clinical and executive levels.

Amanda Bailey-Derrett, a registered midwife and president of the

“As midwives we have

much responsibility, but not enough support” — Amanda Bailey-Derrett, NSWNMA Coffs Harbour Hospital Branch

Coffs Harbour NSWNMA branch, says: “As midwives we have much responsibility, but not enough support. There is definitely a feeling of not being valued by the employer and the government.”

Amanda, who is a registered nurse and registered midwife, believes more midwife-led management structures are necessary.

“Our branch has been advocating for a number of years to increase midwifery management because there is no management at executive level that are midwives [at my workplace]. The highest we have is a midwifery manager who is at level two.”

SCALE-UP MIDWIFERY MODELS OF CARE

Most midwives want to work in continuity of care models, but inflexible work practices and narrow role definitions are limiting their work opportunities, the report notes.

“I previously worked in Midwifery group practice in Coffs Harbour, but I got burnt out in the role of an MGP midwife, as the workload is very high,” says Amanda, who now works in the Coffs Harbour hospital maternity ward.

As an MGP midwife, when “you can be needed for any length of time, and you never know how long your work

AMANDA BAILEY DERRETT (RIGHT), CREDIT – KATIE LAKE

is going to take. And we certainly worked and pushed ourselves hard to ensure our colleagues and the women were looked after.”

The report calls for flexible part-time and job share arrangements to ease burdens on midwives who want to stay in MGP. It also calls for reforms to allow midwives to use the full scope of their practice skills.

“I think there are a lot of midwives who feel like they are obstetric nurses, rather than truly being able to practice midwifery because we have a fairly medicalised model in NSW,” Amanda says.

“A lot of the care is led by the obstetric team rather than midwifery-led, and there is also input from paediatric doctors, who are often reluctant to give a lot of consideration to women’s choices when it comes to birth.

“Evidence shows midwifery-led approach is the gold standard. Those models increase satisfaction for women, but they also increase satisfaction for midwives.”

Nichole Flegg, a midwife and President of NSWNMA Macarthur branch, has noticed significant changes in the profession in the nearly 24 years she has been practising.

“Everything is on computer now: no one sits down and does face to face care that we once had time for.

“I was recently told my time management is terrible because I spend too much time with patients.

“We’ve gone from being human beings talking to human beings, to ticking off a checklist on a computer.

You don’t use your clinical judgement as often and we are losing our clinical skills and critical thinking.”

“It is not actually personalised care it is generic care.”

GROW THE MIDWIFERY WORKFORCE

Universities, health services and government need to increase midwifery student numbers by two per cent, with quarantined places for Aboriginal and Torres Strait Islander midwifery students, the report authors say. They add that students also need to be better supported during clinical placements.

Nichole says the growing administrative demands on midwives means that not only do

BROOKE HARRISON-ROSER

CREDIT – FIRE AND FLY PHOTOGRAPHY

“I was recently told my time management is terrible because I spend too much time with patients.’

— Nichole Flegg , NSWNMA Macarthur branch

experienced midwives have less faceto-face time with women, but they also have less time to spend with midwifery students on placements.

“When everything is actually being done behind a computer screen, and we don’t have the time to spend with women, we are also not able to support our junior staff, our ‘baby midwives’, as much as we would like.”

Support conditions and career pathways in midwifery workforce

Improved working conditions and career pathways all need to be addressed, the report notes.

“We have a very junior-heavy workforce because senior midwives don’t want to stay,” says Amanda.

“They are just quite burnt out with the acuity of the kind of presentations that we are seeing now. The birthrate might be falling, but the acuity is rising, with more complications because of the increased average age of mothers.

“And we have more mums with comorbidities and complications, as well as a lot of anxiety that we need to care for.

“The workload is too high. It is extremely rare to have a ratio of three women to one midwife, but when we do, we enjoy our work because we can provide the kind of really good care we are supposed to provide.

“But that doesn’t happen often: we usually care for four to five women, sometimes higher. And if you’ve got five women and five babies you’ve basically got ten patients.

“The pay issue is definitely an issue. We resuscitate newborns on a regular basis, and we get paid less that someone who paints houses,” says Amanda.

“Women’s and babies’ lives are in our hands, and we don’t get recognised or valued for that.” n

Branch Beat

Branch Beat with NSWNMA Assistant General Secretary Michael Whaites

Industrial action has been an important tool for workers throughout history to try and improve their wages and conditions.

Some nurses and midwives, though, have understandable concerns about going out on strike.

Australia does have laws that safeguard workers from victimisation for taking “protected industrial action” and it is illegal to sack someone, or take adverse action against someone, for participating in a strike during a bargaining period.

Armed with this knowledge our members at Prince of Wales Private Hospital overcame any initial concerns and conducted their first-ever strike, making their voices heard loud and clear in the ongoing campaign for better wages and conditions in their Healthscope facility.

Strike boosts confidence at Prince of Wales Private

Nurses and midwives at Healthscope’s Prince of Wales Private Hospital (POWP) are forming a NSWNMA branch following their first-ever strike.

Strong support for the historic strike in December encouraged POWP members to step up their union involvement via a formal branch structure.

Active Association branches in workplaces are the main mechanism for members to get organised and have a say over local issues affecting their own facility and employer.

Branches also give members an input into the running of the Association’s statewide campaigns and ensure that each workplace has a voice in the Association’s policies and direction.

In the absence of a branch, POWP nurses formed a WhatsApp discussion group for union members and used it to take a poll on possible strike action.

“Our decision was to strike for three hours,” said NSWNMA member at POWP, Tatiana Parra. “We got from 50 to 60 staff members to come out on strike and attend a public rally, which was a phenomenal result for our first strike.”

“Once we have a NSWNMA branch in place it will help to keep people informed, ease a lot of nerves and make us a little bit stronger.”

Prince of Wales Private Hospital (POWP) was the last major Healthscope facility in Sydney to take part in the NSWNMA’s most recent round of strike action.

Healthscope nursing staff are seeking a 15 per cent one-year wage increase, in line with the union’s public sector pay claim.

They are also calling for mandated nurse/midwife to patient ratios, doubling of night shift penalties to 30 per cent, and improved leave entitlements.

Healthscope, which is owned by corporate giant Brookfield (see story

PRINCE

“I think our action in standing up for each other has empowered other nurses who were reluctant to join the strike.”

— Tatiana Parra , NSWNMA member

page 14) was refusing to seriously negotiate on the claims when this issue of The Lamp went to press.

Earlier in 2024, NSWNMA members across Healthscope’s hospitals voted overwhelmingly to apply for a protected action ballot order from the Fair Work Commission.

The Commission approved the application, and the protected action ballot took place in October.

More than 77 per cent of NSWNMA members voted in the ballot, and over 95 per cent of those who participated voted ‘Yes’.

STRIKE EMPOWERED OTHER NURSES

NSWNMA member at POWP, Tatiana Parra, said many nurses and midwives initially were worried about going on strike.

“People were asking what the repercussions were going to be; would we lose our jobs and questions like that,” said Tatiana, a theatre nurse.

“With the help of our NSWNMA officials we tried to reassure people their jobs were secure because we have a right to take protected strike action and make our voices heard.

“I think our action in standing up for each other has empowered other nurses who were reluctant to join the strike.

“People will be more confident when we decide to strike again. Hopefully Healthscope will listen to our message and make a reasonable offer.”

Tatiana said wages paid to Healthscope nurses in NSW had not kept pace with rising prices and lagged behind Healthscope wages in other states.

“I’m a single mum with three kids and I feel I need to take action for their future well-being,” she said.

“The cost of living is ridiculous and the gap between prices and wages is growing.

“I know the reality of financial hardship, and we can’t allow Healthscope to get away with paying sub-standard wages.”n

TATIANA PARRA

Ask Shaye

Expectation to undertake domestic work

I am a Registered Nurse working in the public health system and I am being asked to do domestic work such as cleaning every week. Can I be required to do this?

No. Clause 44 of the Public Health System Nurses’ and Midwives’ (State) Award makes it clear that nurses cannot be required, as a matter of routine, to undertake domestic work such as cleaning, or any other duties which are generally performed by other classifications. It should be noted, however, that exceptions may apply to nurses in an isolation block or where the performance of such duties involves disinfection.

Direct your manager to this clause in the award and contact NSWNMA for further assistance if required.

Employer management of sick leave

Can my employer manage my sick leave?

Yes, your employer can manage sick leave if they believe there is cause for concern such as the amount of sick leave taken, the pattern of sick leave or if you are on sick leave for a lengthy period. All employers should have a sick leave management policy readily available to staff so they are clear on when and how their sick leave might be managed. An employer should notify an employee of its intention to manage their sick leave, providing the reasons for doing so. Typically, management of sick leave will involve meeting with the employee to formulate a plan to:

• provide support to the employee in the case of a chronic illness

When it comes to your rights and entitlements at work, NSWNMA General Secretary Shaye Candish has the answers.

• set requirements about how to notify of a sick leave absence

• require supporting evidence for further sick leave absences

• set a review period.

If you are unsure about whether your employer is managing your sick leave fairly or appropriately, please contact NSWNMA so we can provide more specific advice. Advice on how to tender resignation in the public health system.

I wish to tender my resignation but I’m not sure what to write and I don’t how much notice to give. I work in the public health system. What do I do?

As per clause 45 of the Public Health System Nurses' and Midwives’ (State) Award, you are required to give a minimum of 14 days’ notice in writing. There is no set format for submitting your resignation, but we advise you to keep it as simple and straightforward as possible. For example, “I write to tender my resignation and hereby give 14 days’ notice of the effect of my resignation”.

Employer obligations when a workers compensation certificate of capacity is provided by employee

I work in an aged care facility and have suffered a shoulder injury. I consulted my GP who says I will more than likely make a full recovery and can work in the meantime, however, with some lifting restrictions and on reduced hours. My GP also gave me a workers comp certificate that reflects my restrictions and hours. When I gave my certificate to my manager, they told me that

they had no work for me to do and that I will have to remain off work until I make a full recovery.

The insurance company has accepted my claim and indicates that I should be working to the capacity of the certificate. What can I do?

If any worker has suffered a workplace injury and has a SIRA certificate of capacity, the employer is obliged under current legislation to make every reasonable effort to provide work that is suitable.

Our advice is to think about your usual role and the restrictions your GP has recommended. Write a list of all the duties that will comply with your restrictions, discuss these with your GP and then write to your manager letting them know you have identified suitable duties and requesting again that they provide them.

Please call NSWNMA if your manager still refuses to provide suitable duties. We will require a copy of your certificate, your manager’s contact details, the list of duties and all correspondence with the insurer.

Termination queries

I work for a private employer and am employed under the Nurses Award 2020. My employer has told me that if I do not give adequate notice when resigning my employment, then they can deduct money from my termination payment. Is this correct?

Yes. Clause 32.1(d) of the Nurses Award 2020 provides that an employer may deduct wages due to an employee if they do not give adequate notice upon resignation. However,

the amount that they may deduct is limited to a maximum of 1 week’s wages and must not be unreasonable in the circumstances.

Adverse action

I have been terminated on probation by my employer in the private sector. I’m worried that the real reason I was terminated was because I took sick leave yesterday and I also told them I have a disability. What does this mean?

You may have a claim for adverse action under the Fair Work Act 2009. It does not matter that you were on probation or how long you were employed to make any adverse action claims. You must lodge an adverse action claim to the Fair Work Commission within 21 days of the termination. Some of the grounds of adverse action are: if you were terminated due to a disability, race, age, pregnancy, family or carer responsibilities, subjection to family and domestic violence, religion, temporary absence from work, union membership, because you made a complaint or inquiry about your employment or accessed a benefit under your applicable Award or Enterprise Agreement.

If you are concerned, please get in touch with us as soon as you are terminated for advice.

Understanding different types of leave

I am employed in the private sector. How much family and domestic violence leave am I entitled to?

All employees are entitled to 10 days of paid family and domestic violence leave each year. This includes full-time, part-time and casual employees.

Employees must be experiencing family and domestic violence to be eligible to take paid family and domestic violence leave. Family and domestic violence means violent, threatening, or other abusive behaviour by certain individuals known to an employee that both:

• seeks to coerce or control the employee

• causes them harm or fear.

This entitlement to paid family and domestic violence leave comes from the National Employment Standards (NES) and it is a paid minimum leave entitlement, like annual leave or paid sick and carer’s leave.

Checking compliance with care minutes obligations

How can I find out if a private aged care facility is compliant with their care minutes staffing obligations?

The website myagedcare.gov.au allows you to search each aged care facility and see if they are meeting their minimum target for care minutes per quarter; how much care residents actually received on average; and whether the facility was above or below their target.

Professional Perspectives

Interviews with ACQSC

After an incident at work several nurses and carers were reported to the Aged Care Quality and Safety Commission (ACQSC). I have been invited to an interview and the letter says it is voluntary. Do I have to attend?

Call us if you are a member of the NSWNMA so we can help you navigate the complex and difficult process of an ACQSC investigation. We have an inhouse team of lawyers and paralegals who can assist.

If you receive a letter from the ACQSC inviting you to a voluntary interview you can turn down the invitation and choose not to attend.

• If you choose to attend, please know the interview is video and audio recorded and the questions that will be asked and documents (policies, records CCTV) are not provided in advance. An investigation can be extended to include you as the subject of the investigation. Banning orders are a possibility in some cases.

• If you choose not to attend the ACQSC, the investigation will either be finalised without your participation or the ACQSC may issue a notice compelling you to attend an interview.

The NSWNMA can assist you in some instances to provide a written response or support you at any interview (whether voluntary or involuntary.

Activities that fulfil CPD requirements

I have been told that my annual Basic Life Support (BLS) and fire training do not count towards my CPD. Is this true?

Yes, it is true that annual Basic Life Support and fire training are typically not considered as part of your Continuing Professional Development (CPD) for nursing and midwifery.

While these training sessions are essential for maintaining safety and skills in the healthcare environment, they generally do not meet the specific requirements set by NMBA for CPD.

To ensure you are fulfilling your CPD requirements, it’s important to engage in activities that are directly related to your professional nursing or midwifery practice. When engaging in activities it is important that you are ‘actively learning’ – i.e. learning something new. This can include attending workshops, seminars, or courses that enhance your clinical skills or knowledge in your area of practice.

https://www.nursingmidwifery board.gov.au/codes-guidelinesstatements/codes-guidelines/ guidelines-cpd.aspx

Updating your principal place of practice

I have moved to another state. Do I need to tell AHPRA?

Yes, you have to update your principal place of practice with the NMBA/AHPRA within 30 days, in writing, if you move and work in another state. This is a requirement under section 131 of the Health Practitioner Regulation Law (National Law). If you do not update your principal place of practice, it may constitute behaviour for which health, conduct or performance action may be taken.

You can update your principal place of practice online or complete a form CHPD-00 - Request for change of personal details:

https://www.ahpra.gov.au/ documents/default aspx?record=WD15%2F18313& dbid=AP&chksum=rEo018SLNEU v2zdUlWvhTw%3D%3D

ENs re-entering practice

I was previously working as an Enrolled Nurse but have not practiced for more than 10 years. It has been recommended that I do a re-entry to practice program. However, I can’t seem to find a program for ENs.

As it currently stands, there is no designated re-entry program for ENs. The Association has been advocating for changes with the Nursing and Midwifery Board of Australia (NMBA), but we have not yet seen any modifications to the existing framework.

At this time, if you are looking to re-enter practice, you will need to complete the course again. There may be other avenues such as supervision, however it is important that you contact the Association for further support and advice if you are considering this as an option.

The Association’s professional team answers your questions about professional issues, your rights and responsibilities.

Pressured to work overtime

The ward I work on is constantly short staffed. Every day I go to work and am asked to work overtime. I am fatigued but feel pressured by the nurse manager to stay back. I have previously said that I am tired. Can they keep putting pressure on me to work overtime?

Under the National Law, nurses and midwives have a clear mandate: they must not be directed or pressured by their employers to engage in practices that violate professional standards, ethical guidelines, or codes of conduct. This principle is essential for maintaining the integrity and safety of nursing and midwifery practice.

When managers pressure staff to take on shifts while fatigued, it undermines Principle 7 of the NMBA Code of Conduct, which is centred on health and wellbeing. This principle emphasises the necessity of maintaining both physical and mental health to ensure safe and effective practice. Nurses have an obligation to:

• understand and promote the principles of public health, including health promotion activities and vaccination

• act to reduce the effect of fatigue and stress on their health, and on their ability to provide safe care.

By adhering to these obligations, nurses and midwives can uphold the highest standards of care while safeguarding their own health and the wellbeing of their patients.

Dealing with a vexatious complaint

I have heard nurses in the tearoom talking about a vexatious complaint. What is a vexatious complaint and what should I do if I am facing a vexatious complaint?

A vexatious complaint is one that is baseless, intended to harass, distress or intimidate an individual or organisation and is often not made in good faith. AHPRA and the NMBA are aware of and have a framework regarding vexatious complaints. This includes consequences for practitioners who make vexatious complaints as this may constitute unsatisfactory professional conduct. Signs that a complaint is vexatious include allegations that are clearly unfounded, lack evidence, or are motivated by personal grievances rather than legitimate concerns about professional conduct. If a complaint is made repeatedly without new evidence or has been previously investigated and dismissed, it may be considered vexatious.

If you believe you are the subject of a vexatious complaint, please contact the NSWNMA as soon as possible so that we can provide advice and representation.

For further reading and links to the AHPRA framework go to: https://www.ahpra.gov.au/ Notifications/How-we-manageconcerns/Vexatiousnotifications.aspx

Language ban

I work in aged care and my employer said they will only allow staff to speak English, even at break times. Is this allowed?

While nurses and care workers are required to speak English in the workplace this rule should not apply to break times, including breaks taken in the staff room, as this could be unlawful. You should seek advice from the NSWNMA if you are being asked to only speak English during your work breaks, even if you do not leave the facility to take those breaks.

Legislated collaborative arrangement for PBS

I’m a Nurse Practitioner, my employer has told me I don’t need a legislated collaborative arrangement to prescribe PBS medications anymore. Is that true?

Yes. From 1 November 2024 nurse practitioners and eligible midwives do not need to have specified collaborative arrangements with medical practitioners to prescribe PBS medications and provide Medicare subsidised care, which supports nurses and midwives to work to their full scope of practice. You can find more FAQs here:

https://www.mbsonline.gov.au/ internet/mbsonline/publishing. nsf/Content/FactsheetRemoval%20of%20legislated%20 collaborative%20arrangements

HOW THE SCHEME WORKS

NSWNMA fee waiver for members on parental leave

Did you know, if you’re going on parental leave, paid or unpaid, we’ll waive your Association fees until you return to work? You’ll still be entitled to access advice and receive The Lamp. Contact the Association and let us know when you plan to take parental leave so we can set up your waiver. Call 1300 367 962 or email gensec@nswnma.asn.au www.nswnma.asn.au

WHO condemns destruction of Northern Gaza’s last hospital

The World Health Organization said it was “appalled” by an Israeli raid in late December which shut down the last major hospital still functioning in northern Gaza.

WHO said that “areas of the hospital were burnt and severely damaged during the raid, including the laboratory, surgical unit, engineering and maintenance department, operations theatre, and the medical store.

“Earlier in the day, twelve patients and a female health staff were reportedly forced to evacuate to the (already) destroyed and non-functional Indonesian Hospital where it is not possible to provide any care.”

WHO reported that “some people were reportedly stripped and forced to walk toward southern Gaza. Over the last two months, the area around the hospital has remained highly volatile and attacks on the hospitals and on health workers have occurred almost daily. This week, bombardments in its vicinity reportedly killed 50 people, including five health workers from Kamal Adwan Hospital”.

It said: “With Kamal Adwan and Indonesian hospitals entirely out of service, and Al-Awda Hospital barely able to function, and severely damaged due to recent airstrikes, the healthcare lifeline for those in North Gaza is reaching a breaking point.”

“Hospitals have once again become battlegrounds, reminiscent of the destruction of the health system in Gaza City earlier this year.”

Since October 2023, WHO has repeatedly issued urgent calls to protect health workers and hospitals as per international humanitarian law.

AUSTRALIA

One in three Australian workers at risk to job losses from AI

Australians in both knowledge-based and manual work are more vulnerable to mass job losses through AI than workers in other comparable OECD countries, according to a report by the Social Policy Group.

Artificial Intelligence (AI) is reshaping the global economy at a pace unlike all previous technological revolutions, the report says.

“What makes AI uniquely disruptive is not simply the ability to automate routine work but its capacity to replace entire categories of labour. The structural changes will be tectonic.”

The study found that the first layoffs begin in routine data entry, admin and retail but AI will proceed to replace many high-income, knowledge-based positions traditionally considered aspirational and secure.

“We already see this starting to unfold. The model finds that Australia will be one of the worst-hit OECD countries.”

A Senate report released in November last year recommended using the Occupational Health and Safety framework to bring more oversight to the introduction of AI.

These findings were welcomed by the ACTU.

“So far, large multinational companies and the biggest businesses have been making the major decisions around AI and too often workers have been denied a voice,” said ACTU Secretary Sally McManus.

“The Senate Inquiry has recognised that commonsense protections need to be introduced or strengthened to ensure that working people’s basic rights are preserved, including the right to meaningful consultation.”

‘Hospitals have once again become battlegrounds.’

‘So

far, large multinational companies and the biggest businesses have been making the major decisions around AI and too often workers have been denied a voice.’ — ACTU Secretary Sally McManus

AUSTRALIA

Being overweight tops tobacco as risk to Australians’ health

More than one in three cases of disease and injury in Australia in 2024 could have been avoided, the Australian Institute of Health and Welfare (AIHW) study found.

The AIHW listed 20 risk factors including alcohol use, physical inactivity, poor diet, being overweight or obese and tobacco smoking.

While tobacco use had previously been the leading risk factor contributing to disease burden, a 41 per cent decrease in the rate of its contribution since 2003 has seen being overweight become the most significant factor.

An estimated 8.3 per cent of total disease burden in 2024 was due to overweight (including obesity) and 7.6 per cent was due to tobacco use (excluding vaping). This was followed by dietary risks (4.8 per cent) and high blood pressure (4.4 per cent).

“While Australians are living longer on average, years lived in ill health are also growing, resulting in little change in the proportion of life spent in full health. This contributes to the growing demand and pressures on the health system and services,” said AIHW.

In line with previous years, cancer was the leading group of diseases causing burden in 2024 (16.4 per cent), with 91.3 per cent of this burden fatal and 8.7 per cent non-fatal.

The leading specific causes of disease burden were coronary heart disease (5.5 per cent), dementia (4.5 per cent), back pain and problems (4.3 per cent) and anxiety disorders (3.9 per cent).

‘While Australians are living longer on average, years lived in ill health are also growing … this contributes to the growing demand and pressures on the health system and services.’ AIHW

AUSTRALIA

Moderna’s mRNA vaccines exempt from scrutiny under Morrison-era deal

Health experts voice concerns over a “parallel system” that comes at the expense of “broader societal and consumer perspectives”.

Australians will be offered respiratory vaccines from next year without the usual assessment that ensures they are the most effective available at the best possible price, under the confidential $2 billion onshore manufacturing deal the Morrison government struck with Moderna, The Guardian reported.

The agreement exempts Moderna’s mRNA vaccines from assessment by the Pharmaceutical Benefits Advisory Committee (PBAC), a government memorandum has revealed.

The PBAC is comprised of medical experts and is a key step in ensuring government-purchased vaccines are confirmed as the safest and best quality for their required task, at a reasonable price.

Under the Moderna deal, the government will pay an undisclosed price for an undisclosed percentage of up to 100 million vaccine doses.

The Australian National Audit Office has announced it will investigate the deal.

PBAC has warned that moves aimed at speeding up the distribution process “should not come at the expense” of the other objectives, “including fairness, equitable access, and safe and judicious use of medicines”.

The Moderna mRNA vaccine deal was forged during the COVID-19 emergency but has been extended to cover all respiratory vaccines produced onshore and registered through the Therapeutic Goods Administration – including any for influenza and respiratory syncytial virus.

The Australian National Audit Office has announced it will investigate the deal.

Health job cuts threaten NZ pandemic readiness

An already stretched New Zealand health system faces more swinging job cuts so the conservative National government can deliver on its election promise of tax cuts.

Nearly 1500 more jobs may be cut at Health New Zealand | Te Whatu Ora, the NZ public sector union (NZPSA) says. These job losses are on top of more than 500 voluntary redundancies that had already been accepted. They would include 47 percent (1120 jobs) of the entire Data and Digital group and 24 per cent (358 roles) of the National Public Health Service.

NZPSA spokesperson Ashok Shankar said: "Every day New Zealanders are experiencing a health system that is failing to give them the care and support they need – these cuts will only make that worse.”

"The government has chosen to prioritise billions of dollars in tax cuts for landlords and big tobacco, rather than investing where the real need is – improving the health and wellbeing of New Zealanders. Its priorities are all wrong."

Health experts said there was a strong argument to halt the cuts while New Zealand is implementing the recommendations of its COVID inquiry.

“The major logistical barrier to implementation (of the inquiry’s report) is the downsizing of key government agencies needed to do this work. The situation in New Zealand is in stark contrast with Australia where the release of their report coincided with an announcement of a $251 million investment in establishing a national centre for disease control,” wrote public health academics from the University of Otago in the Conversation

AUSTRALIA

Cost-of-living spike under Dutton’s nuclear proposal: ACTU

Opposition Leader Peter Dutton’s nuclear proposal will drive up power bills and worsen the cost-ofliving for working people, the ACTU says.

The seven nuclear reactor sites proposed by the Coalition are set to cost Australians at least $331 billion – enough to put solar panels on every roof in Australia ten times over, and still have billions left for schools and hospitals, according to ACTU research.

The Institute for Energy Economics and Financial Analysis estimates that Dutton’s nuclear proposal would increase the average Australian household’s electricity bill by $665 a year. By contrast, Australians with rooftop solar are already saving an average of $1594 every year.

A CSIRO report confirmed that nuclear power is at least twice as expensive as renewable energy.

Public health experts have shown that the workers at nuclear power plants and nearby residents are at significantly increased risk of developing mesothelioma, thyroid cancer and circulatory disease.

At least two of Dutton’s proposed nuclear reactor sites are located on active geologic faultlines. A magnitude 4.7 earthquake struck Muswellbrook in the Hunter region earlier in the year, only kilometres away from Dutton’s proposed nuclear site at the Liddell power station.

ACTU President Michele O’Neil said Dutton’s priorities showed he was out of touch with the issues that working people care about.

“Working people can’t afford to see their energy bills go up $665 every year for Peter Dutton’s nuclear proposal when they’re facing cost-of-living pressures,” she said.

The government has chosen to prioritise billions of dollars in tax cuts for landlords and big tobacco.

The CSIRO confirmed that nuclear power is at least twice as expensive as renewable energy.

UNITED STATES

“Demonized”

unions win big on US anti-worker law

Wisconsin’s notorious law, which stripped employees of their collective bargaining rights, has been found to be unconstitutional by an appeal court.

The law, known as Act 10, was passed by Republican governor of Wisconsin Scott Walker in 2010. The act had a significant impact on union membership, pay and benefits. In 2010 Wisconsin had a union density rate of 15.1 per cent. That number dropped to 8.4 per cent in 2023.

The law also forced public sector workers to pay more for healthcare and retirement benefits, resulting in an approximate 8.5 per cent decrease in pay for workers making $50,000 a year.

The act had far-reaching consequences beyond pay and conditions.

A 2024 study found teachers pay had declined from 2010 to 2022 by nearly 20 per cent and about four out of 10 first year teachers either left the state or the profession after six years.

Wisconsin teacher John Havlicek told The Guardian it was not only salary and benefits that were impacted.

“It was all the other things like how many classes you can teach, how many kids can be in a classroom, all kinds of stuff that would be considered working conditions.”

Another study published in 2018 found a 20 per cent drop in average student state test scores in Wisconsin because of the law.

UNITED STATES

Shocking examples of US healthcare profiteering revealed

Selling body parts without consent and billing desperate parents $97,599 for air transport were contenders for the annual Shkreli awards.

The 10 winners of the 2024 Shkreli awards, given annually to the worst examples of profiteering and dysfunction in US healthcare, have been announced by the Lown Institute, a non-profit US think tank, reports the British Medical Journal.

The winners include an oncologist who subjected a healthy patient to cancer treatment for profit, a hospital accused of demanding upfront payments from patients with cancer, and UnitedHealth, the insurance company that has faced a storm of public indignation after one of its executives was murdered in New York.

Lown Institute president Vikas Saini said: “All these stories paint a picture of a healthcare industry in desperate need of transformation.”

One of the contenders for top spot was the case of Sara England and her three-month-old son who experienced severe respiratory distress two months after open-heart surgery. His doctors had him transferred via air ambulance from Salinas, California to a medical centre in San Francisco. Health insurer Cigna later deemed the service “not medically necessary”. The family was given a $97,599 bill.

In a highly competitive year, the top spot went to Steward Health Care, whose CEO, Ralph de la Torre, is accused of prioritizing private equity profits over patient care. His financial scheming led to bankruptcy, leaving hospitals in shambles, employees laid off and communities with less healthcare access.

‘All these stories paint a picture of a healthcare industry in desperate need of transformation.’ Lown Institute

A

study found a 20 per cent drop in average student state test scores in Wisconsin because of the law.

CROSSWORD SOLUTION

Union Made

health+wellbeing

Death, dying and grief - managing your exposure

Nurses and midwives often play a pivotal role in supporting people when they are dying. We are intimately involved with their grief and death and the grief of their loved ones, sometimes in sudden or traumatic circumstances. While this is part of the work and lives of nurses and midwives it may take a toll on our emotional wellbeing and enjoyment of life.

Nurses and midwives are confronted by grief frequently, sometimes even daily, but we commonly believe we should be able to ‘keep going’ and remain detached. We are experts at showing empathy but don’t overly express emotion. We may feel unsure about when and how to show or share our emotions. In most circumstances, showing that you feel loss too is generally well accepted by clients and families.

There is broad research that confirms nurses and midwives grieve and can suffer trauma related to our work. However, we may not fully understand or recognize our emotional responses, particularly if we are fatigued or stressed.

Many nurses and midwives tell us they feel unprepared or unequipped to manage their reactions. It is common for nurses or midwives to not seek support and “push through” until a distressing psychological issue emerges and or until someone else notices or intervenes.

Where to begin?

The first step to prevent this occurring is awareness and early intervention. Education, counselling, and an opportunity to debrief and share your grief can:

• help to develop ‘learned’ resilience

• prevent

- burnout and compassion fatigue

- vicarious trauma and

- trauma-related incidents.

It is important to share how you are feeling. Speak to your manager, a trusted colleague or someone in your personal life. Call Nurse & Midwife Support – a member of our team is available to support you anytime.

Strategies and resources

Learning and practising work-life balance, self-care strategies and communication skills is vital for emotional and professional wellbeing and growth.

Organisations use their own methods to recognise the need to grieve, including providing:

• meditation areas

• memory boards and remembrance ceremonies

• debriefings and

• pastoral care.

Education on grief theories, compassion fatigue, end-of-life care, vicarious trauma and communication skills for nurses and midwives are also useful in equipping nurses and midwives to manage exposure to grief, loss and trauma.

Learning to cope

It may feel confronting and unsettling when you are learning how to express emotion and cope with dying and death. Understanding this reaction is natural and common is a good first step. Recognising early how to cope with your feelings and reactions is a critical life skill and key component to your professional and emotional well-being.

If the death of someone you have cared for or exposure to a traumatic event causes you to have prolonged negative feelings and emotions or physical changes, you may be experiencing vicarious trauma, secondary traumatic stress or burnout.

It is OK to ask for support.

Our service provides free and confidential support 24/7, to nurses, midwives and students Australia wide. If you would like to speak to someone, call 1800 667 877, or you can request support via email.

If you would like to know more about the service before getting in contact — you can look through https:// www.nmsupport.org.au/ accessing-support.

If you would like help dealing with your feelings or experiences relating to death, dying and grief call nurse and midwife support’s confidential support line 24/7 on 1800 667 877.

Vale Robyn Knighten

Honouring a truly remarkable life and legacy

May we all pause to remember and honour our dear NSWNMA colleague, Robyn Knighten, whose passion, dedication, and warmth left a lasting impact on all who knew her. Robyn was not just a colleague she was a friend and a tireless advocate for the nursing and midwifery professions. Her sharp wit, dry humour, and genuine care will be deeply missed by all who knew and worked with her. Robyn’s career was defined by a commitment to the values she held dear: advocacy, solidarity, courage, voice, and integrity. She dedicated her life to improving the lives of nurses and midwives, ensuring their voices were heard and their rights upheld. Her time working in England was pivotal in shaping her career. It was there that Robyn gained invaluable experience in diverse healthcare settings, broadening her understanding of the global nursing community. Her time overseas also strengthened her belief in the power of unity among healthcare professionals, a principle that would guide her work for years to come. Before joining the Association, Robyn’s journey in healthcare advocacy began as a passionate workplace delegate. In this role, she fought for fair working conditions,

improved pay, and better support for nurses and midwives. Robyn’s strong presence in the workplace, combined with her natural leadership and sense of fairness, earned her the respect of her peers.

At the Association, Robyn found her true calling. She joined as an Information Officer and later became a Nurse and Midwife Advocate, where her impact would grow even further. Robyn fought tirelessly for fair conditions, equitable pay, and the recognition of the profession’s value. Her ability to navigate complex negotiations and her unwavering belief in justice inspired those around her. Nurses and midwives knew Robyn was always behind them, supporting their efforts and ensuring their concerns were heard.

Beyond her professional life, Robyn’s vibrant personality shone brightly. She had an unmistakable sense of style, which reflected her creativity and zest for life. She also had a deep love of music and shared this passion with others. Robyn’s quiet laugh, rocking style, and the rhythms of her music brought joy to many.

Even in the final stages of her life, Robyn continued to fight for the profession she loved. Despite facing her own health challenges,

she remained steadfast in her commitment to nurses and midwives. Her strength and resilience in the face of adversity were a true reflection of her character. Robyn’s determination inspired those around her until the very end.

Robyn taught us the importance of finding joy in life’s small moments – a beautiful piece of music or the camaraderie of colleagues working toward a common goal. Her professional legacy is matched by the kindness, humour, and passion she brought to everything she did.

As we remember Robyn, we honour both the incredible advocate she was and the remarkable person she will always be. Her legacy lives on in her family, the lives of the nurses and midwives she touched, in her colleagues and in the values she instilled in all of us. We continue the work she believed in and we honour her memory by fighting for fairness, equality and respect for all nurses and midwives.

Thank you, Robyn. You will always be remembered and your legacy will continue to inspire us every day. n

test your Knowledge

ACROSS

1. Irregular heart rhythm (6.11)

10. Tularemia (6.5)

11. Colour lightly (5)

12. Common ingredient in fertilizers (7)

13. Changeover or switch (9)

14. Recurrent drop in white blood cells (6.11)

16. Viral disease transmitted by animal bites (6)

19. Enzyme that breaks down cells (5)

24. Experienced through touch (7)

25. Irrational fear of darkness (11)

26. Destructive windstorm (7)

27. Excessive bleeding from a ruptured vessel (11)

28. Essential mineral for immune function (4)

30. Having three corners or angles (11)

32. Pathway in nature (5)

33. State of impaired consciousness (17)

DOWN

1. Long-term inflammation of the airways (7.10)

2. Automated or machine-operated (7)

3. Copying or mimicking something (9)

4. Chemical that boosts alertness (8)

5. To give new supplies of food (9)

6. To carry or shelter (7)

7. Large carry bags (5)

8. Compact family vehicle (7)

9. Artery carrying blood to the lungs (7.10)

15. Inflammation of all the structures of the heart (11)

17. Single-celled microorganism (9)

18. What nurses often depicted as (9)

20. Condition (5)

21. Intraarterial (1.1)

22. Source of natural sweetener (9)

23. Fermented milk products (8)

29. Nitrate reductase (1.1)

31. Small bowel obstruction (1.1.1)